Summary of IFOMPT 2016

I was among the lucky three in the world to be supported by IFOMPT (International Federation of Orthopedic Manual Physical Therapists) and Glasgow city with international bursary award to attend IFOMPT 2016 conference in Glasgow this year between 4th – 8th July. I waited for this conference for 4 years after the last one in Canada. This was one of the best conferences I have ever attended in terms of relevance to my practice. It included topics that were varied and incorporated various areas of musculoskeletal practice. The number of parallel sessions made it difficult for me to choose one over another. Most important point in this is, getting the first-hand knowledge from the experts themselves. Another highlight of the conference was finding the world’s best people in the field under the same roof. I met all the expert clinicians and researchers I admired the most. I got to talk with them and share a few words (and some pictures as well), met colleagues I already knew and made new friends. In this post I will highlight the key talks that I attended and in subsequent blogs I will elaborate one at a time.       In the first day, Gwen Jull highlighted the history of manual therapy and how it transformed into evidence based approach by comparing it with different editions of “Grieve’s Modern Musculoskeletal Physiotherapy” textbook. Following Gwen’s talk, one of my favorite speakers of all time, Lorimer Moseley (this was 4th time listening to his talk excluding all the talks over youtube), elaborated the role of pain biology in the patient care. This was an intense talk as the basis of his key messages were derived from complex neuro science and clinical research. The main focus of Lorimer’s talk included the value of educating patient on ‘neurophysiology of pain’ and how this creates changes at the brain level to help treat pain. This was followed Tim Watson’s talk on inflammatory process and its role in pain and tissue healing. This was a contrast talk from Lorimer’s, as Lorimer emphasized on the role of brain on pain whereas Tim tried pulling the audience from ‘the brain’ back to ‘tissue level’. I think this was wisely decided by the conference organizers, to sensitize the audience regarding why ‘brain’ is important in pain, and to remind us that ‘local’ tissue mechanism should not be forgotten. Tim is interested in electrotherapy and has his website where resources are freely downloadable. The last talk I attended was by very own Pain in Motion group highlighting the role of ‘Pain Neuroscience’ in clinical practice on low back pain and complemented Lorimer’s talk by presenting a very interesting case. It was a tough decision to make to choose one session out of many on the second day. I attended a symposium on Patellofemoral pain (PFP) which was exceptionally good. This surely deserves a separate blog post. Indeed, it complements the previous blog where I summarized the 2015 consensus statement on PFP. Following this, Harriet Wittink, highlighted her perspective from the Netherlands on ways to maximize effectiveness of patient education with sound principles behind ways to do this. The next talk was a surprise to me as Susan Greenhalgh brings a patient who suffered Cauda Equina Syndrome (CES) to discuss and expand the details on CES to strengthen knowledge and skills on CES. The talk that followed was by Lisa Roberts on the power of communication and how important communication is for a physical therapist. It was an interesting talk for me personally, as I teach communication for the first year undergraduate students. It was good to know that I am not doing injustice to my students in my attempt to teach them. At the same time, I have newer ways in mind now to improvise my teaching. Following talk was a powerful one by Jeremy Lewis on Shoulder pain and pathology. The day ended by a symposium elaborating how physiotherapists can address psychosocial issues in low back pain. Third day started with very talented Annina Schmid’s talk on expanding understanding of neural pathology. As neural biased treatment is my favourite manual therapy interventions, it was an important talk to help understand the complex solid science behind an intervention that works. Although complicated, it was very clear and had important clinical implications. The talk followed by Mary O’ Kefee’s talk on cognitive functional therapy. I could clearly see that Mary, during her PhD, has extracted the abilities of Peter O’ Sullivan (one of her PhD supervisors) to spellbound the audience. Roger Kerry then discussed the importance of assessment of vascular system in regular clinical practice. I truly agree that screening vascular system is really important as the signs of vascular problems are important red flags. The final talk of the day was, the award winning paper by our very own Joshua A Cleland and colleagues by Josh on how manipulation can help improve pain and function in ankle sprain. Congratulations to Josh for winning the very prestigious David Lamb award at IFOMPT 2016. The penultimate day started with Geoffrey Maitland Award winner Brain Mulligan, followed by Lorimer (again) to reinforce the ways to manage people in pain. One of the talks that I really wanted to attend in this conference was the one on the Gluteal Tendinopathy. After reading JOSPT’s September issue on Tendinopathy, I have started enjoying treating people with lateral hip pain with success. I will write a separate blog post on this. Followed by this was a debate between Manual Therapy versus no Manual therapy on low back pain which was very interestingly organized. The speakers Nadine Foster and Linda Woodhouse tried to prove that Manual therapy is not useful for low back pain, however, Chad Cook and Darren Rivett made their point via professional argument with support from evidence and encouraging sound clinical reasoning for the use of manual therapy for those with low back pain. I completely agree with the arguments and value manual therapy in the management of musculoskeletal patients and clinical reasoning has a very important stand. The final day began by Joel Bialosky who elaborated the mechanisms of manual therapy. Complimenting Joel’s talk, Gwen Jull and Ann Moore emphasized the place of manual therapy in musculoskeletal care and in the undergraduate curriculum. Followed by this, I attended oral presentation sessions to update myself on various ground breaking research in MSK practice. The final day was closed by new IFOMPT president, a personal favourite, Ken Olson. The next IFOMPT conference will be held in Melbourne in 2020. I had a chance to talk with the organizing chair of IFOMPT 2020, who will be highly obliged to have more participants from developing countries. I am looking forward to IFOMPT 2020, how about you?